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1.
Eur Arch Otorhinolaryngol ; 280(11): 5031-5037, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37410145

RESUMO

OBJECTIVE(S): To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS: Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS: Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS: TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.


Assuntos
Litíase , Cálculos dos Ductos Salivares , Cálculos das Glândulas Salivares , Humanos , Ductos Salivares/cirurgia , Ductos Salivares/patologia , Litíase/patologia , Qualidade de Vida , Endoscopia/métodos , Resultado do Tratamento , Glândula Submandibular/diagnóstico por imagem , Glândula Submandibular/cirurgia , Cálculos das Glândulas Salivares/diagnóstico por imagem , Cálculos das Glândulas Salivares/cirurgia , Cálculos dos Ductos Salivares/patologia , Cálculos dos Ductos Salivares/cirurgia
2.
Eur Arch Otorhinolaryngol ; 276(1): 101-106, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30402795

RESUMO

BACKGROUND: Septal perforations consist in an anatomic defect of the mucosal, cartilaginous and/or bone tissues of the nasal septum. A huge variety of approaches and techniques for nasal perforation repair have been reported. METHODOLOGY/PRINCIPAL: Between January 2008 and January 2017, 38 patients were treated for nasal septal perforation in Department of Otorhinolaryngology Head and Neck Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain. A novel approach is presented based on microscope. Septal perforation closure was performed with endonasal bilateral advancement flaps-established technique and autologous cartilage and muscle temporal fascia grafts. We performed a retrospective review of closure rates and complications. RESULTS: A postoperative follow-up of at least 12 months was performed in 37 patients. The mean size of perforation was 1.33 cm. After the withdrawal of the silicone splints, perforations were completely closed in all cases. However, during the follow-up, four patients resulted in a reperforation, so our closure rate was 89.19%. For all cases, symptoms related to septal defect were solved. Only one case was reported of local infections that was resolved with antibiotics in a few days. CONCLUSIONS: Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.


Assuntos
Perfuração do Septo Nasal/cirurgia , Septo Nasal/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Rinoplastia/métodos , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Adulto Jovem
3.
Eur J Immunol ; 42(11): 3038-48, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22930439

RESUMO

We report the results of the Theravac-01 phase I trial, which was conducted to evaluate the safety and immunogenicity of a poxvirus-based vector, NYVAC, expressing Gag, Pol, Nef, and Env from an HIV clade B isolate. NYVAC-B vaccine was injected intra-muscularly into ten HIV-infected patients successfully treated with antiretroviral therapy, twice on day 0 and again at week 4. Safety and immunogenicity were monitored for 48 weeks. HIV-specific T-cell responses following immunization were quantitatively analyzed using an IFN-γ ELISPOT assay and qualitatively characterized for their functional profile (including multiple cytokines secretion plus cytotoxic and proliferation capacity) by polychromatic flow cytometry. Our results indicate that the NYVAC-B vaccine is safe and highly immunogenic, as indicated by increased HIV-specific T-cell responses in virtually all vaccinees. Interestingly, both an expansion of preexisting T-cell responses, and the appearance of newly detected HIV-specific CD4(+) and CD8(+) T-cell responses were observed. Furthermore, immunization mostly induced an increase in Gag-specific T-cell responses. In conclusion, NYVAC-B immunization induces broad, vigorous, and polyfunctional HIV-specific T-cell responses, suggesting that poxvirus-based vaccine regimens may be instrumental in the therapeutic HIV vaccine field.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Infecções por HIV/imunologia , Infecções por HIV/terapia , HIV/imunologia , Vacinas Virais/administração & dosagem , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/virologia , Linfócitos T CD8-Positivos/virologia , Processos de Crescimento Celular/efeitos dos fármacos , Processos de Crescimento Celular/imunologia , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Interferon gama/sangue , Interferon gama/imunologia , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Suíça , Vacinas Virais/imunologia
4.
Ann Otol Rhinol Laryngol ; 132(2): 217-220, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35189727

RESUMO

INTRODUCTION: Chronic obstructive sialadenitis (COS) is an entity that causes a marked loss in patient quality of life, including changes in eating habits and a progressive loss of gland function. It is characterized by repeated episodes of painful glandular swelling often requiring emergency care. There are multiple causes of COS, including lithiasis, strictures, anatomical variants, and others. The development of specific imaging tests such as magnetic resonance (MR) sialography or sialendoscopy have increased knowledge of these obstructions and how to specifically treat them. CASE SUMMARY: We present an unusual case of a woman with a years-long history of chronic obstructive sialadenitis in which an abnormal path of Wharton's duct was in evidence. This duct, which was atrophic and smaller in diameter, opened in the tonsillar fossa rather than lateral to the lingual frenulum. This case, the first in vivo description of its kind, was confirmed by MR sialography and sialendoscopy. DISCUSSION: Congenital anomalies of the submandibular duct are a rare finding, but may cause COS. Therefore, COS requires a detailed diagnostic study, usually by ultrasound, MR sialography and sialendoscopy, to rule out complex anatomical variants.


Assuntos
Ductos Salivares , Sialadenite , Feminino , Humanos , Ductos Salivares/patologia , Qualidade de Vida , Endoscopia/métodos , Sialadenite/diagnóstico , Sialadenite/etiologia , Sialografia/efeitos adversos , Doença Crônica , Glândula Submandibular/patologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-36272442

RESUMO

BACKGROUND AND OBJECTIVES: Interest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility. MATERIAL AND METHODS: A prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. RESULTS: All the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31. CONCLUSIONS: The CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis.


Assuntos
Qualidade de Vida , Sialadenite , Humanos , Reprodutibilidade dos Testes , Estudos Prospectivos , Inquéritos e Questionários , Doença Crônica , Estudos Observacionais como Assunto
6.
Acta Neurol Belg ; 122(5): 1149-1162, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35842896

RESUMO

BACKGROUND: Recent developments in wearable powered exoskeletons (WPE) allow gait training (GT) for patients after spinal cord injury (SCI). Two recent meta-analyses on GT using WPE showed promising results for paraplegic patients (PP). To this date, there is no review focusing on tetraplegic patients (TP). OBJECTIVES: The main objective of this review was to assess feasibility and safety of GT using WPE in patients after tetraplegia. METHOD: This systematic review was performed according to PRISMA-S guidelines. Two independent reviewers searched several databases for studies on GT using WPE for TP. Primary outcomes concerned the number, type and severity of reported adverse events (AE). Secondary outcomes examined potential additional health benefits (AHB). RESULTS: Forty-one studies (6 randomized trials, 24 cohorts and 11 cases series) were selected, including 166 TP, 26 with complete lesions (AIS A) and 71 with level of injury above C6. Minor AE were reported in 17 TP, concerning cutaneous, cardiovascular or musculoskeletal systems. Occurrence of AE is significantly higher in a PP population compared to TP (p value = 0.001). Only one major AE concerned a TP. Studies of low level of evidence suggest that GT using WPE could lead to improvements in walking parameters, cardiovascular efficiency and to a reduction of spasticity. DISCUSSION AND CONCLUSION: GT using WPE is a feasible and safe intervention for TP. To minimize occurrence of AE, a good patient selection and preparation is proposed. Future clinical trials should be performed to confirm current trends in terms of efficacy and potential AHB.


Assuntos
Exoesqueleto Energizado , Traumatismos da Medula Espinal , Dispositivos Eletrônicos Vestíveis , Estudos de Viabilidade , Marcha , Humanos , Paraplegia , Quadriplegia , Traumatismos da Medula Espinal/complicações , Caminhada
7.
Br J Oral Maxillofac Surg ; 60(10): 1385-1390, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36109276

RESUMO

The purpose of this paper was to describe the characteristics of salivary calculi and their relationship to epidemiological factors, through a cross-sectional study. We analysed 100 calculi obtained in 2017-2021. Patient data including age, time since onset of symptoms, gland involved, and site of location in the salivary system were studied. The calculi were studied to determine their morphological features using scanning electron microscopy and energy dispersive plain radiographic analysis. Most of the calculi had formed in the submandibular gland (SG) (82%). The mean age of patients at onset was 45.83 years; patients presenting parotid gland (PG) stones were somewhat older (p = 0.031). The mean time since the onset of symptoms was longer in PG calculi (p = 0.038). The most common lithiasis site was the main duct (74%), followed by the hilum (22%). Hilar stones were the largest (p < 0.05) and heaviest (p = 0.028). Octacalcium phosphate (OCP) was the most common crystalline phase (Cp) founded, followed by hydroxyapatite (HA) and whitlockite (WH). Specifically, OCP had a higher presence in PG calculi (p = 0.029) and WH was the most common phase in SG calculi (p = 0.017). The most prevalent site of lithiasis was the main duct, and the largest and heaviest calculi were found in the SG. PG stones were associated with a longer history of symptoms and older age. OCP was the most frequent Cp of the calculi studied, and the main Cp in PG stones. WH was the predominant Cp in SG stones. The Cp of the calculi was not influenced by location, patient age, or time of symptoms.


Assuntos
Litíase , Cálculos dos Ductos Salivares , Cálculos das Glândulas Salivares , Humanos , Pessoa de Meia-Idade , Cálculos das Glândulas Salivares/diagnóstico por imagem , Cálculos das Glândulas Salivares/epidemiologia , Litíase/diagnóstico por imagem , Litíase/epidemiologia , Estudos Transversais , Endoscopia , Estudos Retrospectivos , Cálculos dos Ductos Salivares/diagnóstico por imagem , Cálculos dos Ductos Salivares/epidemiologia
8.
Otolaryngol Head Neck Surg ; 160(6): 1042-1047, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30642220

RESUMO

OBJECTIVE: (1) To identify p16 protein in laryngeal squamous cell carcinoma (LSCC) specimens and to correlate it with the presence of human papillomavirus (HPV) found in these specimens from a previous study. (2) To analyze p16 impact on 10-year overall and disease-free survival. STUDY DESIGN: Retrospective case series with oncologic database chart review. SETTING: Academic tertiary care hospital. SUBJECTS: A total of 123 samples of LSCC (taken from the glottis only) from patients treated with primary surgical resection between 1977 and 2005. METHODS: p16 protein expression was analyzed through immunohistochemistry and compared with the presence of HPV established in our previous studies. Results were compared with histologic, clinicopathologic, and survival parameters, with a 10-year follow-up. RESULTS: Of the samples, 39.02% were positive for p16, but only 11.38% were positive for both p16 and HPV. The p16+ cohort showed a significant improvement in disease-free survival ( P = .0022); statistical significance was not achieved for overall survival. p16+ cases had fewer relapses over time, with no relapses after a 2-year follow-up. Age at the time of diagnosis and tobacco consumption were the only epidemiologic factors that influenced overall survival. CONCLUSION: The expression of p16 protein was a beneficial prognostic factor for disease-free survival among patients with LSCC of the glottis, with no relapses after a 2-year follow-up.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Inibidor p16 de Quinase Dependente de Ciclina/sangue , Glote , Neoplasias Laríngeas/mortalidade , Papillomaviridae , Infecções por Papillomavirus/mortalidade , Idoso , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/virologia , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Laríngeas/sangue , Neoplasias Laríngeas/virologia , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/sangue , Infecções por Papillomavirus/complicações , Estudos Retrospectivos , Taxa de Sobrevida
9.
EBioMedicine ; 24: 195-204, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28970080

RESUMO

BACKGROUND: In a placebo-controlled trial of the peptide-based therapeutic HIV-1 p24Gag vaccine candidate Vacc-4x, participants on combination antiretroviral therapy (cART) received six immunizations over 18weeks, followed by analytical treatment interruption (ATI) between weeks 28 and 52. Cell-mediated immune responses were investigated as predictors of Vacc-4x effect (VE) on viral load (VL) and CD4 count during ATI. METHODS: All analyses of week 28 responses and fold-changes relative to baseline considered per-protocol participants (Vacc-4x:placebo=72:32) resuming cART after week 40. Linear regression models with interaction tests were used. VE was estimated as the Vacc-4x-placebo difference in log10-transformed VL (VEVL) or CD4 count (VECD4). FINDINGS: A lower fold-change of CD4+ T-cell proliferation was associated with VECD4 at week 48 (p=0.036, multiplicity adjusted q=0.036) and week 52 (p=0.040, q=0.080). A higher fold-change of IFN-γ in proliferation supernatants was associated with VEVL at week 44 (p=0.047, q=0.07). A higher fold-change of TNF-α was associated with VEVL at week 44 (p=0.045, q=0.070), week 48 (p=0.028, q=0.070), and week 52 (p=0.037, q=0.074). A higher fold-change of IL-6 was associated with VEVL at week 48 (p=0.017, q=0.036). TNF-α levels (>median) were associated with VECD4 at week 48 (p=0.009, q=0.009). INTERPRETATION: These exploratory analyses highlight the potential value of investigating biomarkers in T-cell proliferation supernatants for VE in clinical studies.


Assuntos
Vacinas contra a AIDS/administração & dosagem , Linfócitos T CD4-Positivos/citologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , HIV-1/fisiologia , Carga Viral/efeitos dos fármacos , Vacinas contra a AIDS/farmacologia , Adulto , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Feminino , HIV-1/imunologia , Humanos , Imunidade Celular , Interleucina-6/metabolismo , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem
10.
Medicine (Baltimore) ; 94(3): e437, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25621699

RESUMO

Pancreatic hemolymphangioma is a very rare benign tumor. There were only 10 reports of this disease until June 2014.The aim of the present study was to describe a hemolymphangioma in the neck and body of the pancreas in a 57-year-old woman.The method used in the present study consists of description of the clinical history, image lab features, and pathological result.The patient complained of a 10-day history of epigastric discomfort. Abdominal computed tomography (CT) showed a cystic-solid tumor with an irregular shape, in the neck and body of the pancreas. The tumoral cystic wall and its internal division could be seen intensified on contrast-enhanced CT images compared with those on precontrast images. The pathological examination confirmed the diagnosis.The clinical feature of pancreatic hemolymphangioma includes a lack of specificity. The CT appearance combined with age and sex may be useful in making an early diagnosis.


Assuntos
Linfangioma/diagnóstico por imagem , Linfangioma/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico , Fatores Etários , Feminino , Humanos , Linfangioma/cirurgia , Pessoa de Meia-Idade , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Fatores Sexuais , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Acta otorrinolaringol. esp ; Acta otorrinolaringol. esp;74(2): 116-123, marzo-abril 2023. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-217390

RESUMO

Antecedentes y objetivos: El interés en la sialoadenitis obstructiva crónica está aumentando con la introducción de la sialoendoscopia. Es necesario contar con un instrumento para evaluar la calidad de vida en los pacientes con sialoadenitis obstructiva crónica que permita mejorar el manejo clínico y apoyar la investigación. Los objetivos del presente trabajo son diseñar un cuestionario en español para evaluar la calidad de vida en los pacientes con sialoadenitis obstructiva crónica, denominado CSOC, y evaluar su fiabilidad, validez y viabilidad.Material y métodosEstudio prospectivo, multicéntrico, observacional, en el que se incluyeron pacientes con diagnóstico de sialoadenitis obstructiva crónica. Se realizaron una búsqueda bibliográfica y entrevistas con pacientes para la generación de las preguntas del cuestionario. A continuación, un panel de expertos evaluó la validez de contenido. La validez de constructo fue evaluada en una muestra de 120 pacientes y 100 controles. Los pacientes contestaron un CSOC, un short form-36 (SF-36) versión en español y una escala visual analógica (EVA). Se evaluó la viabilidad, la fiabilidad, la consistencia interna, la validez de constructo y la sensibilidad al cambio.ResultadosTodos los pacientes encontraron comprensible el instrumento. El tiempo requerido para completar el CSOC pre y postsialoendoscopia fue de 5,7 y 4,5min, respectivamente. El coeficiente α de Cronbach fue muy alto para el CSOC pre y postsialoendoscópico (0,90 y 0,94, respectivamente). La correlación con las dimensiones del SF-36 fue negativa y positiva con la EVA. La puntuación media del CSOC en el grupo con sialoadenitis fue de 28,63 (antes de la sialoendoscopia) y de 8,33 (después de la sialoendoscopia). En el grupo control la puntuación media del CSOC fue de 1,31.ConclusionesEl CSOC es comprensible, factible, fiable y representativo de la calidad de vida en pacientes con sialoadenitis obstructiva crónica.


Background and objectives: Interest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility.Material and methodsA prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed.ResultsAll the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94, respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31.ConclusionsThe CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis. (AU)


Assuntos
Humanos , Sialadenite , Qualidade de Vida , Otolaringologia , Inquéritos e Questionários
12.
Artigo em Inglês | IMSEAR | ID: sea-162085

RESUMO

Introduction: Th e ischaemic disorders as a complication of intra-aortic balloon pump counterpulsation (IABP) could be deleterious in critically ill patients with myocardial failure and cardiogenic shock. Th is study is a pilot to predict the length of the descending aorta to select the optimum IABP size for Asian patients. Methods: Th e somatometric features from 80 Chinese patients were used: gender, age, height, body mass index, body surface area, trans-pyloric plane. Moreover, the aortic length from the origin of left subclavian artery to the orifi ce of the celiac trunk (LSA-CT) measured from tomographic scan examination. Th e variables to predict the length from the LSA-CT were studied in four types of predictive statistical analysis: nonlinear regression analysis, tree model, linear regression, and log_linear regression. Th e model was defi ned by obtaining the R square. Results: Th ere were 59 males (mean age 53.9 years SD 13.2, height 170.8cm SD 4.0) and 21 females (mean age 58.7 years SD 7.8, height 160.2 cm SD 6.8). LSA-CT distance was found to be 279.5 SD 31.34 mm. Th e length of distance from the jugular notch to trans-pyloric plane was 273.8cm SD 12.5. Th e body mass index was 25.6 Kg/m2 SD 3.8 and the body surface area 1.8 m2 SD 0.1. Th e tree model for predicting the distance to the left subclavian artery to the celiac axis was chosen due to obtained an R2 square of 0,829. Th e comparison between the tomographic values and results of the tree model was realized with a nonparametric test. Wilcoxon signed-rank test showed that the values of computed tomograhy scan did not show a statistically signifi cant diff erence with the results of the tree model (Z = -0.827 p =0.408). Conclusion: Th e tree model for predicting the distance from the left subclavian artery to the celiac trunk, could be an accurate guide to choosing an adequate catheter length of intra-aortic balloon pump counterpulsation in Asian patients.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Povo Asiático , China , Feminino , Humanos , Balão Intra-Aórtico/efeitos adversos , Balão Intra-Aórtico/instrumentação , Balão Intra-Aórtico/métodos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios X , Adulto Jovem
13.
J Exp Med ; 205(1): 63-77, 2008 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-18195071

RESUMO

The EuroVacc 02 phase I trial has evaluated the safety and immunogenicity of a prime-boost regimen comprising recombinant DNA and the poxvirus vector NYVAC, both expressing a common immunogen consisting of Env, Gag, Pol, and Nef polypeptide domain from human immunodeficiency virus (HIV)-1 clade C isolate, CN54. 40 volunteers were randomized to receive DNA C or nothing on day 0 and at week 4, followed by NYVAC C at weeks 20 and 24. The primary immunogenicity endpoints were measured at weeks 26 and 28 by the quantification of T cell responses using the interferon gamma enzyme-linked immunospot assay. Our results indicate that the DNA C plus NYVAC C vaccine regimen was highly immunogenic, as indicated by the detection of T cell responses in 90% of vaccinees and was superior to responses induced by NYVAC C alone (33% of responders). The vaccine-induced T cell responses were (a) vigorous in the case of the env response (mean 480 spot-forming units/10(6) mononuclear cells at weeks 26/28), (b) polyfunctional for both CD4 and CD8 T cell responses, (c) broad (the average number of epitopes was 4.2 per responder), and (d) durable (T cell responses were present in 70% of vaccinees at week 72). The vaccine-induced T cell responses were strongest and most frequently directed against Env (91% of vaccines), but smaller responses against Gag-Pol-Nef were also observed in 48% of vaccinees. These results support the development of the poxvirus platform in the HIV vaccine field and the further clinical development of the DNA C plus NYVAC C vaccine regimen.


Assuntos
Vacinas contra a AIDS/uso terapêutico , Vacinas Virais/uso terapêutico , Vacinas contra a AIDS/química , Animais , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Códon , Ensaio de Imunoadsorção Enzimática/métodos , Mapeamento de Epitopos , Humanos , Peptídeos/química , Fenótipo , Vacinas , Vacinas Virais/química , Produtos do Gene env do Vírus da Imunodeficiência Humana/genética , Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética , Produtos do Gene nef do Vírus da Imunodeficiência Humana/genética
14.
Proc Natl Acad Sci U S A ; 104(41): 16233-8, 2007 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-17911249

RESUMO

We studied CD8 T cell responses against HIV-1, cytomegalovirus, Epstein-Barr virus, and influenza in 128 subjects and demonstrate that polyfunctional CD8 T cell responses, also including IL-2 production and Ag-specific proliferation, are predominantly driven by virus epitopes restricted by HLA-B alleles. Interestingly, these protective CD8 T cells are equipped with low-avidity T cell receptors (TCRs) for the cognate virus epitope. Conversely, HLA-A-restricted epitopes are mostly associated with "only effector" IFN-gamma-secreting, with cytotoxicity, and with the lack of IL-2 production and Ag-specific proliferation. These CD8 T cells are equipped with high-avidity TCR and express higher levels of the T cell exhaustion marker PD-1. Thus, the functional profile of the CD8 T cell response is strongly influenced by the extent to which there is stimulation of polyfunctional (predominantly restricted by HLA-B) versus only effector (restricted by HLA-A) T cell responses. These results provide the rationale for the observed protective role of HLA-B in HIV-1-infection and new insights into the relationship between TCR avidity, PD-1 expression, and the functional profile of CD8 T cells.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Infecções por HIV/imunologia , Antígenos HLA-B/genética , Estudos de Coortes , Citomegalovirus/imunologia , Genótipo , Infecções por HIV/genética , HIV-1/imunologia , Antígenos HLA-A/genética , Herpesvirus Humano 4/imunologia , Humanos , Técnicas In Vitro , Interleucina-2/biossíntese , Ativação Linfocitária , Orthomyxoviridae/imunologia , Receptores de Antígenos de Linfócitos T/metabolismo
15.
s.l; Tarea, Asociación de Publicaciones Educativas; dic. 1990. 284 p. (BIBLIOTECA DE EDUCACION DE ADULTOS, 1).
Monografia em Espanhol | LILACS | ID: lil-107103

RESUMO

El libro presenta el resultado de la VI Jornadas Iberoamericanas de Educación de Adultos y reúne un conjunto de ponencias de los participantes, en las que reflexionan sobre las tendencias de la corriente histórica de la educación de adultos y popular, dentro del contexto actual de la vida democrática. Estas ponencias orientan a analizar las relaciones entre educación de adultos y democracia, teniendo como referentes las dimensiones actuales y futuras de ambos aspectos en relación con las tendencias políticas, sociales y económicas del desarrollo; las orientaciones surgidas de la teoría del desarrollo local; la concepción misma de la democracia en los países iberoamericanos; el rol del Estado y de la sociedad civil en los procesos actuales de democratización; los derechos humanos; el papel de las ONGs en la construcción democrática; la función cumplida por la educación de adultos en democracias más consolidadas. Asimismo, se incluyen algunas experiencias, las que muestras caminos alternativos y estrategias de acción para que la educación de adultos y popular se constituyan en instrumentos eficaces de la democracia política y la convivencia social


Assuntos
Humanos , Adulto , Democracia , Educação
16.
Cochabamba; s.n; 1987. 28 p. tab.
Não convencional em Espanhol | LILACS | ID: lil-202102

RESUMO

Este trabajo busca establecer la correlación inmunológi ca entre la madre chagásica y la sangre del cordón umbilical, entre parasitemia de cordón umbilical y el chagas materno; determinar la incidencia de niños prematuros y bajo peso al nacer con la infección chagásica materna.


Assuntos
Humanos , Recém-Nascido , Feminino , Sorologia , Sorologia/normas , Doença de Chagas
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